I hereby acknowledge that I am the PARTICIPANT who will be registering for the WSDPT Foot Fitness Class) and will claim responsibility for registering in any online class or workshop.

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I hereby acknowledge that any PARTICIPANT who engages in a training program, physical program, exercise program, class (online or in person), or any other event (hereinafter collectively ‘TRAINING’) sponsored and/or conducted by, or on behalf of, Marika Molnar PT PC dba Westside Dance Physical Therapy, its officers, directors, employees, related companies, successors, assigns, independent contractors, and/or training instructors (hereinafter collectively ‘PROVIDER’), will participate in said TRAINING, including, but not limited to, engaging in physical activity and exercise associated with the TRAINING, and utilizing equipment, instruction, services, facilities, and premises that are part of the TRAINING, entirely and expressly at the PARTICIPANT'S own risk.

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I understand that it is my responsibility as the PARTICIPANT to consult with a physician prior to participating in in online remote exercises classes and/or lessons offered by Westside Dance Physical Therapy as deemed necessary. I represent and warrant that I as the PARTICIPANT am physically fit and have no medical conditions, which would prevent my full participation in a class.

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Further,  I agree that the PARTICIPANT, and all successors, heirs and assigns, to completely and forever release and hold harmless the PROVIDER from any and all liability for injury, death, damages, any loss to PARTICIPANT and/or the personal property of the PARTICIPANT, as well as any claim, demand, lawsuit, injury, and damage of whatever type or nature (hereinafter collectively ‘CLAIM’), even if caused by acts or omissions, including but not limited to negligence, of PROVIDER.

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In addition, as further consideration for the minor being permitted to participate in said TRAINING, I as the PARTICIPANT authorize the PROVIDER to take photographs and/or video images of PARTICIPANT (hereinafter collectively ‘PICTURES’) during the TRAINING for use by PROVIDER in advertisements and/or other promotional materials for similar future events.

 

PARTICIPANT hereby expressly consents to such use and forever releases any and all rights that PARTICIPANT has as to his or her image as depicted in the PICTURES, as well as any and all other rights PARTICIPANT may have to the PICTURES.

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I as the PARTICIPANT further expressly agrees that the foregoing WAIVER AND RELEASE OF LIABILITY is intended to be as broad and inclusive as permitted by law, and that if any portions of this WAIVER AND RELEASE OF LIABILITY are found invalid for any reason, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

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Additionally, I as the PARTICIPANT, authorize the use of electronic means as needed to complete and submit this WAIVER AND RELEASE OF LIABILITY agreement.

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Furthermore, both the PARTICIPANT and PROVIDER expressly agree that New York law shall apply to any CLAIM arising from the TRAINING and that any lawsuit arising from a CLAIM shall be venued in New York City, New York.

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PLEASE TAKE NOTICE that if the foregoing is acceptable, I as the PARTICIPANT must acknowledge that I have read, understood and expressly agree that I am bound by this WAIVER AND RELEASE OF LIABILITY.

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PLEASE TAKE FURTHER NOTICE that by completing and signing this form any person other than the parent or legal guardian of the PARTICIPANT is also expressly representing that he or she is the authorized agent of PARTICIPANT for purposes of binding PARTICIPANT pursuant to the terms of the WAIVER AND RELEASE OF LIABILITY and that PROVIDER is relying upon this representation.

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If it is later determined that the person purporting to bind PARTICIPANT is not, in fact, the PARTICIPANT, the person making the representation will defend, indemnify, hold harmless and be personally liable to PROVIDER for all damages incurred by PROVIDER arising from any CLAIM by PARTICIPANT, including but not limited to payment of any judgment, settlement, and the fees and costs of PROVIDER'S attorneys and experts.

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Cancellation Policy: No refund is given for any cancellation received after three days before the event. To cancel your registration please email contact@westsidedancept.com

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Program Changes: Westside Dance Physical Therapy makes every effort to hold classes at the dates, times and locations, and with the instructors and classes specified on our website and brochures. We do reserve the right to cancel and/or change event dates, times, instructors and locations although this happens very rarely. In the very unlikely event that circumstances dictate that we do postpone or cancel a class, you will be refunded your registration fee in full. Westside Dance Physical Therapy is not responsible for workshops, or portions of workshops that attendee misses due to illness, emergency, or other event beyond the control of WSDPT.

 

I HAVE READ THE ABOVE RELEASE AND WAIVER OF LIABILITY AND FULLY UNDERSTAND ITS CONTENTS. I VOLUNTARILY AGREE TO THE TERMS AND CONDITIONS ABOVE.

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